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New Relief for the Hypertension Headache

Headaches are one of the most common complaints of people with high blood pressure. But doctors had thought that blood pressure had to be quite high to cause such pain. Now a new study adds to the growing body of evidence that even mild hypertension causes headaches. Moreover, the headaches subside with hypertension medication.

Researchers reviewed the data from seven randomized, double-blind,
placebo-controlled trials on 2,673, middle-aged, primarily white patients
with mild-to-moderate hypertension (154/101 mm Hg). Dr. Lennart Hansson of
the University of Uppsala in Sweden, and colleagues report their results in the June 12,
2000, Archives of Internal Medicine.

During the studies, which lasted 8 to 12 weeks, 1,987 patients
received the blood pressure medication irbesartan (Avapro), an angiotensin
II receptor blocker. The other patients received a placebo. In most of the
studies, the irbesartan dosage was 75- to 150 milligrams per day.

Of patients taking irbesartan, 17 percent had headaches, compared
with 22 percent of those taking the placebo. Even fewer patients may have
had headaches if they had received larger doses of the drug, the researchers
note.

Among the placebo group, 19 percent of the patients with diastolic
blood pressure of less than 90 mm Hg had headaches, while 27 percent of
those with blood pressure of 100 mm Hg or greater had them. Younger people (less than fifty years old) were more likely to have headaches than were older individuals. Also, 18
percent of the men and 29 percent of the women had headaches. The researchers also associated increasing diastolic, but not systolic, blood pressure with new or worsening episodes of headache [why would this be?].

"The link between headache and hypertension has often been
attributed to anger, anxiety, or the adverse effects of drug therapy," the
team notes.

The study did not examine the effects of other blood pressure medications on headaches, nor did it study the effects of lowering blood pressure without medication.

According to the authors, the results suggest that "physicians should take patient reports of headache seriously and take steps to aggressively reduce blood pressure, preferably with agents that have superior tolerability profiles, to improve overall quality of life."

Coauthors of the study have worked for the manufacturers of
irbesartan, Bristol-Myers Squibb Co., of Princeton, N.J., which funded the
study. Further studies may be needed, as the reports were based on patients' memories.

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